28 de fev de 2013

Child contracts Legionnaires' disease at Starship Children's Hospital

A child is receiving intensive treatment for Legionnaires' disease believed to have been contracted during their stay at Starship Children's Hospital in Auckland.

Hospital director of health Dr Richard Aickin said that did not mean the health of other patients or staff were at risk.
The patient tested positive for Legionella but follow-up tests on nearby patients had returned negative results, he said.
There is no reason for the public to be alarmed, said Dr Aickin.
"Legionella does not spread from person-to-person and there is no reason for anyone who is or has been at Starship to be concerned.
"The usual incubation period has passed without a second case being identified, so staff are confident it is an isolated case."
Legionnaires' disease is an environmental organism usually originating from standing water that causes a chest infection.
It is the first case of Legionnaires' disease acquired by a patient at Starship or Auckland City Hospital, Dr Aickin said.

Legionella Outbreak

CBS News

PITTSBURGH (KDKA) — The latest family to wonder what the VA knew and when they knew it is the family of 74-year-old Clark Compston.

Compston’s family told the Pittsburgh Post-Gazette they were told he contracted Legionnaire’s while a patient at the VA hospital. However, Compston’s death certificate lists lung cancer as the cause of death with no mention of Legionnaire’s and the family is left to wonder whether if he might have had more time.

Sandy Riley of Swissvale also said Monday night that she believed her brother, 65-year-old Mitch Wanstreet of Jeannette would be alive today, had he not come in contact with the Legionella bacteria while at the Oakland VA hospital last summer.

Wanstreet died in July, about 10 days after being admitted first to the VA facility in Aspinwall, then being transferred to Oakland.

16 de fev de 2013

Legionella bacteria became so pervasive in the Pittsburgh VA's Oakland hospital that it contaminated an outdoor decorative fountain, making the water feature one possible source in the fatal outbreak of Legionnaires' disease revealed during the fall, the Centers for Disease Control and Prevention found.

A 56-page CDC report obtained by the Tribune-Review outlines stark details in the case, including that workers super-heated and flushed pipes at the hospital a half-dozen times from January 2011 to October 2012.

VA officials first told the public of hospital-linked Legionnaires' cases in mid-November, about two weeks after the CDC first told the VA that in-house bacteria were causing pneumonia.

The repeated super-heating makes it “pretty clear they recognized there was a problem,” said Janet Stout, a former VA official, Legionnaires' researcher and co-founder of the Special Pathogens Laboratory, Uptown. “The fact that they had to do it repeatedly suggests that it was not done hot enough and long enough.”

A Pittsburgh VA spokesman could not be reached for comment Monday.

Sen. Bob Casey Jr., D-Scranton, who sparked an internal investigation at the VA, said the CDC report “still leaves many unanswered questions.”

“It is imperative that these events are reported appropriately to both the CDC and the public in order to keep people both safe and informed,” he said.

VA leaders say they sought CDC help late last year in evaluating the outbreak of Legionnaires', a waterborne and sometimes-fatal form of pneumonia. They had acknowledged only five cases linked to hospital tap water contaminated with Legionella, the bacteria that causes the disease.

A bombshell summary of CDC findings released last week at a congressional hearing showed 21 cases since January 2011 probably originated at the Oakland hospital or the VA's H.J. Heinz Campus in O'Hara. Five of those patients died.

The Pittsburgh VA said Friday another Legionella-infected patient died in late January, though it remains unclear whether that veteran came in contact with the bacteria in the Oakland hospital or elsewhere.

The complete CDC report dated Jan. 25 illustrates more detail found by the federal reviewers, who are tracing the outbreak's genesis before 2011, the document shows. Among highlights in the report sent to the VA and state Health Department by Dr. Alicia Demirjian in the CDC Division of Bacterial Diseases:

• Legionella was “widespread throughout the hospital” in Oakland by fall 2012. Sixty-six percent of environmental samples collected by the CDC in November showed Legionella growth at the Oakland hospital. One round of tests found “every water sample we took was positive for Legionella except for hot water collected from two stand-alone hot-water heaters,” the report reads.

• In some instances, reviewers discovered a delay of more than two days in relaying patients' Legionella-positive test results from the hospital laboratory to an internal infection-prevention team. The prevention team “does not typically contact (the doctors) with results,” though it did meet with an administrator for infectious diseases to classify Legionnaires' cases.

• Extensive construction at the hospital probably contributed to the Legionella outbreak.

Rep. Tim Murphy, R-Upper St. Clair, voiced concern about the delay between the discovery of Legionella in the hospital lab and when the lab got word out. Former VA official Dr. Victor Yu, a University of Pittsburgh professor whom the VA fired, called it “incomprehensible that they didn't tell physicians that Legionella had re-entered the drinking water.”

“If there was a fire in the building, would you pull the fire alarm and call 911, or would you send the fire department a letter?” Murphy said.

Dr. Ronald Voorhees, the acting health director for Allegheny County, said he felt the VA's actions “have been on target.”

“I think there have been hiccups along the way,” Voorhees said. “But once they recognized they had a problem, they took action to treat all their water.”

He said he was still reviewing the CDC report and would be “looking into appropriate responses.”

“I think the bigger issue is that we know water systems — not just at the VA — have Legionella,” Voorhees said. “We are in desperate need of having a certified method for how to deal with it.”

A congressional subcommittee under the House Committee on Veterans' Affairs is weighing federal standards for Legionella prevention. County and VA standards have long held that hospitals should be concerned when testing finds Legionella in more than 30 percent of samples.

Federal epidemiologist Lauri Hicks told the congressional subcommittee Feb. 5 that the CDC knows of no safe level for Legionella.